Introduction
The respective dosage of Clexane® is selected according to the respective area of application. Important: The indicated dosages are only approximate values and must always be selected and adjusted by a physician according to the respective disease.
Dosage
The dose of Clexane® is determined according to body weight or the risk of disease or illness. – Thrombosis prophylaxis: If the risk is low, 20mg /0.2ml of Clexane® are prescribed, if the risk is high, 40mg /0.4ml. – Thrombosis therapy: If a thrombosis is present, 1mg Clexane® per kilogram body weight is administered twice daily.
- Unstable angina pectoris / non-ST elevation myocardial infarction (NSTEMI): 1mg per kilogram body weight is given every 12 hours. – ST elevation myocardial infarction (STEMI): A bolus of 30mg is given first, followed by 1mg per kilogram of body weight. Clexane® is injected under the skin into the subcutaneous fatty tissue – except for intravenous bolus administration (administration = s. c. = subcutaneous injection; so-called “abdominal injection”).
In the case of very severely impaired kidney function (creatinine clerance < 30 ml/min) the Clexane® dose is reduced. 1mg Clexane® corresponds to an anti-Xa dose of 100 IU (international units). This means that 1mg Clexane® 100 IU inhibit factor Xa.
Clexane for renal failure
In patients with impaired renal function, excretion of Clexane® is impaired. The extent to which this occurs depends on the extent of the renal failure. If excretion is reduced, the concentration of Clexane® in the body is increased and, since Clexane® is a blood thinner, the risk of bleeding increases.
Therefore, depending on the severity of the renal failure, the dose of Clexane® must be adjusted. In patients receiving Clexane® for thrombosis prophylaxis, the dose should be reduced once daily to 20 mg subcutaneously once a day from a glomerular filtration rate (GFR) of 15-30 ml/min. Otherwise the dose is 40 mg in healthy kidney patients.
Clexane® should no longer be used if the GFR is below 15 ml/min. In addition to thrombosis prophylaxis, Clexane® is also used to treat thrombosis and embolism. Here a higher dose is necessary than for thrombosis prophylaxis.
Up to a GFR of 30 ml/min no dose adjustment is necessary. At a GFR between 15-30 ml/min a dose of 1 mg/kg is still recommended, but the dosage interval should be extended from 12 to 24 hours. Instead of the 2 times daily administration Clexane should therefore only be used once a day.
Clexane for overweight
Clexane® is usually dosed according to the formula 1 mg/kg, i.e. weight-adapted. This means, for example, that a patient who weighs 70 kg receives 70 mg Clexane (Clexane 0.7) while a patient who weighs 100 kg receives 100 mg Clexane (Clexane 1.0). There is therefore no need to adjust the dose upwards or downwards in the case of overweight or obesity.
